Healthcare Provider Details

I. General information

NPI: 1316324924
Provider Name (Legal Business Name): EUNJOO LEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2015
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N SANTA ANITA AVE STE 800
ARCADIA CA
91006-3129
US

IV. Provider business mailing address

150 N SANTA ANITA AVE STE 800
ARCADIA CA
91006-3129
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA141045
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: